Differential Impact of Central and Global Visual Field Progression on Quality of Life in Glaucoma.
Gunasegaran Gopikasree, Moghimi Sasan, Walker Evan, Nishida Takashi, Liebmann Jeffrey M, Fazio Massimo A, Girkin Christopher A, Zangwill Linda M, Weinreb Robert N
AI Summary
This study found central visual field progression impacts glaucoma patients' quality of life more than global progression, suggesting current assessments may underestimate patient-centered outcomes.
Abstract
Purpose
To determine the impact of progression of central visual field (VF) and global VF on vision-related quality of life (VRQOL).
Design
Retrospective cohort study.
Methods
This study included 364 eyes of 235 primary open-angle glaucoma participants who had at least five 24-2 VF tests over a minimum of 2-year follow-up. The slopes of global mean deviation (MD) and central mean total deviation (MTD 10 ) (12 test points within the central 10° of 24-2) were calculated. Analyses were conducted using different slope thresholds to define VF-based progression, and mean composite National Eye Institute Visual Function Questionnaire Rasch-calibrated scores associated with these progression thresholds were quantified using linear mixed-effects models.
Results
The baseline 24-2 VF MD of all participants was -5.6 (95% CI -6.4, -4.9) decibels (dB). At baseline, eyes with MTD 10 progression had significantly worse 24-2 VF MD compared to those without MTD 10 progression. When fast progression was defined as MTD 10 slope <-0.50 dB/y, fast progressors had a mean baseline 24-2 MD of -9.71 dB (95% CI -11.89, -7.53) compared to -5.24 dB (95% CI -6.02, -4.46) in slow progressors (P < .001). Eyes exhibiting MTD 10 progression consistently displayed worse mean composite VRQOL scores across various thresholds compared to global MD. Notably, a similar level of VRQOL impairment was observed at a lower threshold for MTD 10 compared to MD, consistent across all glaucoma severity groups. In the overall cohort, eyes progressing at a rate of -0.5 dB/y or faster for MTD 10 had a mean composite VRQOL score comparable to those progressing at -1.0 dB/y or faster for global MD.
Conclusions
Central VF change had a greater impact on VRQOL compared to global VF change. Conventional assessments based on global MD may underestimate the effect of central VF changes. Refining progression detection strategies to include central VF is necessary to better reflect changes in patient-centered outcomes like VRQOL.
MeSH Terms
Shields Classification
Key Concepts6
Central visual field (VF) change had a greater impact on vision-related quality of life (VRQOL) compared to global VF change in 364 eyes of 235 primary open-angle glaucoma participants.
Conventional assessments based on global mean deviation (MD) may underestimate the effect of central visual field (VF) changes on vision-related quality of life (VRQOL) in primary open-angle glaucoma participants.
Refining progression detection strategies to include central visual field (VF) is necessary to better reflect changes in patient-centered outcomes like vision-related quality of life (VRQOL) in primary open-angle glaucoma participants.
In the overall cohort of primary open-angle glaucoma participants, eyes progressing at a rate of -0.5 dB/y or faster for central mean total deviation (MTD 10) had a mean composite vision-related quality of life (VRQOL) score comparable to those progressing at -1.0 dB/y or faster for global mean deviation (MD).
At baseline, eyes with central mean total deviation (MTD 10) progression had significantly worse 24-2 visual field (VF) mean deviation (MD) compared to those without MTD 10 progression in 364 eyes of 235 primary open-angle glaucoma participants.
When fast progression was defined as central mean total deviation (MTD 10) slope <-0.50 dB/y, fast progressors in primary open-angle glaucoma had a mean baseline 24-2 visual field (VF) mean deviation (MD) of -9.71 dB (95% CI -11.89, -7.53) compared to -5.24 dB (95% CI -6.02, -4.46) in slow progressors (P < .001).
Related Articles5
Mobility performance in glaucoma.
Observational StudyIs poor life expectancy a predictive factor in the progression of primary open angle glaucoma?
Case-Control StudyPostural stability in primary open angle glaucoma.
Observational StudyCorrelation of visual field with quality-of-life measures at diagnosis in the Collaborative Initial Glaucoma Treatment Study (CIGTS).
Cohort StudyContrasting the use of 2 vision-specific quality of life questionnaires in subjects with open-angle glaucoma.
Observational StudyIs this article assigned to the wrong chapter(s)? Let us know.